Mood Disorders

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Questions and Answers

What is a key requirement for diagnosing a major depressive episode (MDE)?

Presence of at least three manic symptoms.

At least five core symptoms lasting for a minimum of 2 weeks. (correct)

Symptoms must not cause any significant distress.

Symptoms must be caused by substance use.

Which of the following is NOT a symptom associated with manic episodes?

Feeling unusually fatigued. (correct)

Distractibility.

Inflated self-esteem or grandiosity.

Increased goal-directed activity.

What distinguishes symptoms of mixed features in mood disorders?

Presence of exclusively depressive symptoms.

Symptoms must only be attributable to substance use.

Meeting criteria for manic or hypomanic episodes with additional depressive symptoms. (correct)

Symptoms that occur during hypomanic episodes only.

Which of the following neurovegetative symptoms is associated with major depressive episodes?

Weight loss or gain. Signup and view all the answers

What is commonly seen in more than 50% of patients experiencing manic episodes?

Psychotic symptoms. Signup and view all the answers

Which of the following symptoms is predominantly associated with major depressive disorder (MDD)?

Loss of interest in daily activities Signup and view all the answers

What is the typical age range for the peak onset of major depressive disorder (MDD)?

20s Signup and view all the answers

Which of the following is NOT considered a neurovegetative symptom of depression?

Guilt and worthlessness Signup and view all the answers

Which of the following medical conditions is linked to the development of mood disorders?

Cerebrovascular disease Signup and view all the answers

What criteria must be present for diagnosing a major depressive episode?

Symptoms for nearly every day for at least 2 weeks Signup and view all the answers

What differentiates mood episodes from mood disorders?

Mood episodes are distinct periods of abnormal mood, while mood disorders involve consistent patterns of mood episodes. Signup and view all the answers

Which of the following describes the core features of major depressive disorder?

Pervasive low mood and reduced capacity for pleasure. Signup and view all the answers

What is a common neurovegetative symptom of depression?

Sleep disturbances and changes in appetite. Signup and view all the answers

Which disorder is characterized by episodes of mania and depression?

Bipolar I disorder. Signup and view all the answers

Which of the following is NOT typically a criterion for diagnosing major depressive disorder?

Severe mania that interferes with daily functioning. Signup and view all the answers

How is normal bereavement differentiated from major depressive disorder?

Bereavement is a normal reaction to loss, while major depressive disorder is characterized by pervasive changes in mood. Signup and view all the answers

What role does diurnal mood variation play in the diagnosis of depression?

It is a common feature of major depression where mood is worst in the morning and improves throughout the day. Signup and view all the answers

What distinguishes bipolar II disorder from bipolar I disorder?

Bipolar II disorder features hypomania instead of full manic episodes. Signup and view all the answers

Study Notes

Mood Episodes

Major Depressive Episode (MDE): At least five core symptoms of depression, including depressed mood and inability to experience pleasure (anhedonia), for at least two weeks. Symptoms should not be caused by substances or medical conditions, and must cause significant distress or impairment.
Manic Episode: Persistently elevated, expansive, or irritable mood, increased goal-directed activity or energy lasting at least one week (or any duration if hospitalization is necessary), including at least three of the following (four if mood is only irritable):
- Distractibility
- Inflated self-esteem or grandiosity
- Increased goal-directed activity (socially, at work, or sexually) or psychomotor agitation
- Decreased need for sleep
- Flight of ideas or racing thoughts
- More talkative than usual or pressured speech
- Excessive involvement in pleasurable activities with high risk of negative consequences (e.g., shopping sprees, sexual indiscretions)
Symptoms must not be caused by substances or medical conditions, and must cause significant distress or impairment. More than half of patients with manic episodes experience psychotic symptoms.
Mixed Features: Criteria for a manic or hypomanic episode, with at least three symptoms of an MDE present for the majority of the time. These criteria must be present nearly every day for at least one week.

Mood Disorders due to Other Medical Conditions

Medical Causes of a Depressive Episode: Cerebrovascular disease, endocrine disorders (diabetes, Cushing syndrome, Addison disease, hypoglycemia), hyper/hypothyroidism, hyper/hypocalcemia, Parkinson disease, viral illnesses, carcinoid syndrome, cancer, collagen vascular disease.
Medical Causes of a Manic Episode: Metabolic (hyperthyroidism), neurological disorders (temporal lobe seizures, multiple sclerosis).

Mood Disorders

Major Depressive Disorder (MDD): Marked by episodes of depressed mood associated with loss of interest in daily activities. Patients may not acknowledge their depressed mood or express vague somatic complaints (fatigue, headache, abdominal pain, muscle tension, etc.)
- Lifetime prevalence: 12% worldwide. Onset at any age, but peaks in the 20s. 1.5-2 times more prevalent in women than men during reproductive years. No ethnic or socioeconomic differences.
Bipolar I Disorder: Characterized by manic episodes with or without depressive episodes.
Bipolar II Disorder: Characterized by hypomanic episodes and at least one major depressive episode.
Persistent Depressive Disorder (Dysthymia): Chronic, low-grade depression lasting at least two years.
Cyclothymic Disorder: Pattern of alternating periods of hypomanic and depressive symptoms that does not meet the criteria for a full-blown manic or depressive episode.

Psychotic Features in Mood Disorders

Delusions: False beliefs held with strong conviction, despite clear evidence to the contrary.
Hallucinations: Perceptual experiences without an external stimulus, occurring in any sensory modality.

Bereavement

Also known as simple grief. It is a normal reaction to a major loss, usually of a loved one. It is not a mental illness.
Symptoms are typically self-limited.
Normal bereavement should not include gross psychotic symptoms, disorganization, or active suicidality.

Depressive Disorder

Brief feelings of sadness or anger in response to challenges are part of everyday life experience.
The term "depression" should be restricted to individuals with a pervasive change in mood, meaning deterioration that persists across different situations, endures for a prolonged period with little variability, and involves distinctive patterns of associated symptoms.
Dysphoria: Depressive feelings.

Core Features of Depression

Pervasive low mood: Minimal variation in mood throughout the day; often worse upon waking in the morning, improving as the day progresses. This pattern is known as diurnal mood variation (DMV) and is associated with moderate to severe depression.
Reduced capacity for pleasure (anhedonia): Total inability to feel pleasure or enjoyment.
Depressed mood and loss of interest or pleasure are the key symptoms of depression.
Patients may describe feeling blue, hopeless, in the dumps, or worthless.

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Description

Test your knowledge on major depressive and manic episodes in mood disorders. This quiz covers the essential symptoms and criteria required for identifying these conditions. Understand the nuances and impacts of these mood episodes on individuals.